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Ten frequently asked questions concerning cure of spinal cord injury

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    FAQ #1: Will There Be A Cure For Spinal Cord Injury?

    I just posted the detailed documented answer to the first question: Will There Be a Cure For Spinal Cord Injury? at http://wiseyoung.wordpress.com/2008/...l-cord-injury/. Merry Christmas to everybody!

    Comment


      "In summary, there are many reasons to be optimistic that there will be not just one but many “cures” for spinal cord injury. I defined a cure as a treatment that would make it so that an observer who did not know you wouldn’t be able to tell that you have spinal cord injury. I believe that there will be a cure because much data indicate that the spinal cord can regenerate and many therapies restore function in animal studies. One or more of these will be shown to be successful in people in the coming years, hopefully sooner rather than later. At the present, we don’t have the clinical trial infrastructure to test all the therapies that have shown promise in animal models. It is likely that some combination of the therapies will provide cures. However, we must be aware that the translation of findings from animal studies to human clinical trials will not necessarily be smooth and there will be bumps along the way."

      - understood and a huge THANK YOU

      MERRY CHRISTMAS Dr. Young!!!!!!!!!!!!!!!!!

      Comment


        FAQ #2: When Will the Cure Be Available for Spinal Cord Injury

        I posted the detailed answer to the second frequently asked question: http://wiseyoung.wordpress.com/2009/01/01/182/

        Comment


          Well I guess you can say that is great news, as long day you can mentally physically hold on for another 10 years, another 10 years that would be 22 years in a wheelchair 52 years old, I think a lot of us will have passed on the too far out of shape,
          personally don't think I will be around that long with a C3 complete, I can not except 10 more years, hopefully maybe someplace else different country without role of bureaucratic red tape will have something sooner. Sorry to be negative but think about it 10 years... but keep on working at a repair for the injury.
          keiffer66

          Comment


            if we are willing to participate, why can't they run the trials on us? even if there were a .000001 chance that it would help, i would volunteer to be a lab rat. and i'm sure i'm not the only one. why test on rats, when actual people with SCI will do it?
            ___________
            T12-L1 since 11-27-06

            Comment


              FAQ #3: Will the Cure be for Chronic Spinal Cord Injury?

              Here is the third of the series of articles on Frequently Asked Questions...

              http://wiseyoung.wordpress.com/2009/01/03/

              Comment


                Some very impressive information. thank you for your hard work on these articles , all are very well done.
                oh well

                Comment


                  Thanks Dr. Young, informative and promising articles. Is this a misspeak here; do you mean sufficient, rather than insufficient:
                  Spasticity and spasms are proof that the spinal cord is alive and kicking. People who have flaccid paralysis below the injury site may have had some damage to the spinal cord below the injury site. However, this does not necessarily mean that the spinal cord is “dead”. It does mean that there is insufficient excitability to cause spasticity and spasms.
                  Originally posted by Wise Young View Post
                  Here is the third of the series of articles on Frequently Asked Questions...

                  http://wiseyoung.wordpress.com/2009/01/03/
                  Last edited by Wise Young; 4 Jan 2009, 5:41 AM.
                  get busy living or get busy dying

                  Comment


                    Thanks Dr. Young, informative and promising articles. Is this a misspeak here; do you mean sufficient, rather than insufficient:
                    Spasticity and spasms are proof that the spinal cord is alive and kicking. People who have flaccid paralysis below the injury site may have had some damage to the spinal cord below the injury site. However, this does not necessarily mean that the spinal cord is “dead”. It does mean that there is insufficient excitability to cause spasticity and spasms.
                    Originally posted by Wise Young View Post
                    Here is the third of the series of articles on Frequently Asked Questions...

                    http://wiseyoung.wordpress.com/2009/01/03/
                    Thanks for pointing these things out. I need proof-readers. However, in this case, I think that I do mean insufficient excitability to produce produce spasticity or spasms.

                    In my experience, the spinal cord below the injury site is seldom "dead". I use to think this, particularly in people who describe a condition that sounds like a conus injury. A conus injury denotes an injury to the tip of the spinal cord that innerves the bladder, anus, and pelvic area. If it is damaged, neuronal replacement therapy is necessary. Sometimes, I would think from the verbal description that a person has had a conus injury [source]/forum/showthread.php?t=112914[/source], only to find that the person has some sparing. Even conus injuries often show evidence of some neuronal activity in the sacral segments.

                    So, when people tell me that their spinal cord is "dead" below the injury site and that they don't have any reflexes in the legs, I usually ask quite a lot of questions to make sure that it is so. Some people may be taking high doses of baclofen. Others may be hyporeflexic but they still have some reflexes, like the withdrawal reflex or Babinsky. The only way to tell for sure about the excitability of the spinal cord is to do electrophysiology. One can stimulate the cord and look for the H and M waves.

                    For many years, people talked about the spinal cord being in "shock". Spinal shock mean absence of reflexes and was first described by Sir Charles Sherrington in monkeys, after he cut their spinal cords. I must say that I have seldom seen true spinal shock in patients that last longer than several days in patients.

                    Wise.

                    Comment


                      spasm's REF. FAQ 3

                      Dr wise young you say that christopher reeve got some function back after year's .Do you know if he got any stemcell's or any Drugs to make this happen or was it strong spasm's ref FAQ 3 For i have strong spasm's and have not lost any muscle tone 3 year's past t6-10 complete I do all the exercise standing up EX EX i am on 120 mg a day of baclofen i try all other drug's stil no good if i go for a Baclofen pump it will stop my spasm's but it will but me back if a cure come's along any suggestion
                      AS I SIT HERE IN MY CHAIR . I LOOK OUT UPON THE GROUND .I WONDER WILL I EVER GET UP AND WALK A ROUND ??


                      http://justadollarplease.org

                      Comment


                        Dr. Young, Thank you for this thread and the time you spend answering our questions. My understanding is that some thoracic and cervical injuries may respond better to prospective treatments than lower level injuries due to the nature of the spinal cord. Would any of the therapies currently in the pipeline help people with lower level injuries? My son is an L1 (burst fracture) with a functional level of about L3. Also, could nerve bridging potentially restore bladder function at that level?

                        Just curious.

                        Many thanks.
                        Last edited by PeanutsLucy; 4 Jan 2009, 7:54 PM.
                        Ugh, I've been kissed by a dog!
                        Get some hot water, get some iodine ...
                        -- Lucy VanPelt

                        Comment


                          Originally posted by skeaman View Post
                          Dr wise young you say that christopher reeve got some function back after year's .Do you know if he got any stemcell's or any Drugs to make this happen or was it strong spasm's ref FAQ 3 For i have strong spasm's and have not lost any muscle tone 3 year's past t6-10 complete I do all the exercise standing up EX EX i am on 120 mg a day of baclofen i try all other drug's stil no good if i go for a Baclofen pump it will stop my spasm's but it will but me back if a cure come's along any suggestion

                          Skeaman,

                          Christopher engaged in only three kinds of experimental therapies that I knew of. The first is the intensive exercise program that he had. He stood in a standing frame at least an hour a day and he also used as FES bike on most days. This led to his good musculature. He had "thunder thighs" and he said that his bones were in very good condition (I did not see the data). The second is that he received a diaphragm stimulator implant using endoscopic implantation rather than open surgery. He did suffer from infections in the period after the implantation and I don't know whether this was from the implant or not. Third, Christopher received some GM1, monosialic ganglioside, at least for one day. I understand that, because he is severely allergic to a number of drugs, his doctors were concerned that he might be allergic to this and gave him some heparin before-hand. Note that heparin itself is probably more allergenic than the GM1. In any case, he developed a hypersensitivity response after he received the heparin and GM1, requiring admission to the hospital. In my opinion, he did not receive the GM1 long enough to have any benefit from that drug. This was never publicized because he did not want his experience to harm further development of GM1.

                          To my knowledge, Christopher Reeve never received any stem cells or other experimental therapies. John McDonald has attributed his recovery to the exercise program that he had. One case does not constitute proof of cause-and-effect. I don't know of any comparable situation of somebody with a C1/2 injury who then did extensive daily exercises.

                          Wise.

                          Comment


                            Originally posted by PeanutsLucy View Post
                            Dr. Young, Thank you for this thread and the time you spend answering our questions. My understanding is that some thoracic and cervical injuries may respond better to prospective treatments than lower level injuries due to the nature of the spinal cord. Would any of the therapies currently in the pipeline help people with lower level injuries? My son is an L1 (burst fracture) with a functional level of about L3. Also, could nerve bridging potentially restore bladder function at that level?

                            Just curious.

                            Many thanks.
                            Lucy, I am writing an article about that... will post soon. Wise.

                            Comment


                              Originally posted by Wise Young View Post
                              Thanks for pointing these things out. I need proof-readers. However, in this case, I think that I do mean insufficient excitability to produce produce spasticity or spasms.

                              In my experience, the spinal cord below the injury site is seldom "dead". I use to think this, particularly in people who describe a condition that sounds like a conus injury. A conus injury denotes an injury to the tip of the spinal cord that innerves the bladder, anus, and pelvic area. If it is damaged, neuronal replacement therapy is necessary. Sometimes, I would think from the verbal description that a person has had a conus injury [source]/forum/showthread.php?t=112914[/source], only to find that the person has some sparing. Even conus injuries often show evidence of some neuronal activity in the sacral segments.

                              So, when people tell me that their spinal cord is "dead" below the injury site and that they don't have any reflexes in the legs, I usually ask quite a lot of questions to make sure that it is so. Some people may be taking high doses of baclofen. Others may be hyporeflexic but they still have some reflexes, like the withdrawal reflex or Babinsky. The only way to tell for sure about the excitability of the spinal cord is to do electrophysiology. One can stimulate the cord and look for the H and M waves.

                              For many years, people talked about the spinal cord being in "shock". Spinal shock mean absence of reflexes and was first described by Sir Charles Sherrington in monkeys, after he cut their spinal cords. I must say that I have seldom seen true spinal shock in patients that last longer than several days in patients.

                              Wise.
                              Okay, I see what you mean now, thanks. Guess I got excited, reading too fast. I always just figured spasms were caused by opposing muscles fighting each other, by natural flexing or contracting, or reflex response to touch or movement. The idea that spasms indicate the cord is "alive" is exciting and promising - the chicken running around with his head cut off is an excellent example, good point. Keep up the work, good sir, I hope someday SCI won't be the life-sentence it is now. Thank you.
                              get busy living or get busy dying

                              Comment


                                Wise, Time magazine did report on CR's one time experience with GM-1 in an interview. They didn't mention the Heparin but did go into detail about his doctor having to shoot him full of epi or atrapine. He coded at home. After that got around docs giving it under the "compassionate use" waiver were required to give the first injection in an office or hospital equipped with code carts.
                                Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, "I will try again tomorrow."

                                Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied and are based solely on my experiences as a SCI patient. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

                                Comment

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